Provider Demographics
NPI:1346300886
Name:HAKIM, KAMRAN (DDS)
Entity Type:Individual
Prefix:
First Name:KAMRAN
Middle Name:
Last Name:HAKIM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6815 EASTERN AVE
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:BELL GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90201-3919
Mailing Address - Country:US
Mailing Address - Phone:323-560-2595
Mailing Address - Fax:323-560-5653
Practice Address - Street 1:6815 EASTERN AVE
Practice Address - Street 2:SUITE A-1
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201-3919
Practice Address - Country:US
Practice Address - Phone:323-560-2595
Practice Address - Fax:323-560-5653
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice